What is Rebound Therapy?
Rebound Therapy (RT) is the use of the trampoline to allow opportunities for an
individual to ‘move’ and experience the stimulating feedback from this dynamic
movement. It is a fun, accessible and fully inclusive activity that is particularly
relevant for students with special educational needs although anyone can take
part. RT was developed in the 1970s by Eddy Anderson (MCSP; Cert Ed) who
initially promoted the concept of using the moving surface of the trampoline ‘bed’
to provide recreation for those with profound and multiple disabilities (National
Rebound Therapy Consultancy, 2008).
Why Rebound Therapy for Autistic Spectrum Disorders?
Rebound therapy is essentially a technique used for remedial effects (CSP,
2007). Many people on the autistic spectrum have vestibular or proprioceptive
issues due to sensory integration problems. This relates to behaviour and
learning especially among those who have problems self-regulating.
Trampolining is a highly sensory activity that provides a lot of stimulation and
sensory feedback. I have found from observing students in my lessons that even
the simple action of bouncing organises the body and the senses. Students are
generally more relaxed and happy after trampolining.
The physical, psychological and educational benefits for students with autism
and Rebound Therapy are many (Randell and du-Mont, 2005). But for me the
most inspiring feature is that children see it as something fun and the PE teacher
can be creative and totally design the session to suit the individual. No two
students are the same so no two RT programmes are the same. Apart from the
obvious health benefits associated with vigorous exercise I believe students
develop better control over gross motor skills and also postural balance. Many of
the students whom I teach have movement issues and do not feel happy
exploring their space but when trampolining they are confident to move in
different ways.
Autism is often described as a developmental or intellectual disorder. Jones,
Walley, Leech, Paterson, Common, Metcalf (2006) evaluated their 16-week
rebound therapy-based exercise programme. Participants were persons with
severe intellectual disability and associated challenging behaviour and also
profound physical and intellectual disabilities. They found that participation in the
exercise programme was associated with positive effects on behaviour, health
and physical competence. Equally in their later pilot study, Jones, Walley, Leech,
Paterson, Common, Metcalf (2007) developed and implemented a ‘needs-led
exercise programme based on rebound therapy’ for people with profound and
intellectual disabilities. They concluded that challenging behaviour decreased
and alertness increased when the programme was followed for 16-weeks.
Miller (2007) and The Saturn V Gymnastics and Trampolining Association report
a variety of benefits of RT, including adjustments of muscle tone, facilitation of
movement, sensory integration and an increase in cardiovascular fitness and
communication skills. In responses to questionnaires in his study on
effectiveness of RT as a method of occupational therapy intervention, Hancock
(2003) indicated that rebound therapy did have a positive effect on children with
motor coordination difficulties which often occur alongside autism.
How RT can be implemented into the PE curriculum
After training as an ‘operator’ I introduced RT to my school as a key part of my
autism-friendly PE curriculum called the ‘FeelGood programme’. I have included
RT activities under the ‘gymnastics’ area of activity in the national curriculum but
it has many links to other areas of activity as well lending itself to cross-curricular
links in most other subjects in the national curriculum.
Firstly I had to introduce students, as well as staff, to the concept of both passive
and active bouncing. I had to provide trampoline sessions that catered for the
more able students who could follow more complex instructions but also the
students who would benefit from bouncing as a therapy. The lesson structure
often comprises a warm-up; a skill session and free-time but this is very much
dependant on student behaviour on the day! Sometimes offering a lesson that is
too structured to someone who is just not in the mood will lead to information
overload and behaviours that are not conducive to a safe trampoline session.
Flexibility is needed to provide an alternative lesson that allows the student
choice and success.
I have found that a structured RT lesson provides a very multisensory approach
to physical education. Problem solving and sequential thinking can be developed
and individually paced. Trampolining can also provide quite a reactive situation
for students who do not always respond well to making quick decisions or reflex
actions. In gymnastics typically most individuals struggle with artistic thinking and
concepts but when on the trampoline my observations have suggested that
students gain the freedom to be creative. By asking students to initially copy
movements or sequences of movements a memory bank of reactions are
established. Then when they are given ‘free-time bouncing’ they gain a wider
range of movements and skills from which to select and become confident using.
The next step is to then transfer these and movement patterns to other activities
that use similar skills.
I have found that the trampoline is made even more attractive when, where
relevant, used alongside other equipment such as a small parachute, and soft
colourful balls with stimulating textures or sensory toys. This initiates a play
situation which is very important to children with autism as they often struggle to
play appropriately and display rigid thinking.
Dynamic and interesting effects can be created for students who do not readily
respond to instructions or information and who require a much more powerful
motivator. Students who do not readily communicate generally request a specific
toy to use or ask for interaction during the ‘free-time bouncing’ element of the
session. Communication is enhanced by a two-way movement dialogue between
adult and student because the activity is relaxed and non-threatening. There is
certainly more scope to use the potential of rebound therapy to develop and
assess communication.
Also relevant to the field of autism is the presentation of information as too much
information or information presented in the wrong way can confuse and cause a
barrier to learning. The trampoline is actually a very organised work zone with
clear visual boundaries and expectations so listening and looking is immediately
focussed around one area. I find, as do support staff, that students are more
likely to listen first time to an instruction or question when on the trampoline.
RT case study
Karen is a 14-year old student with autism and additional learning difficulties. She
has 1: 1 funding to access the school curriculum and help support her needs.
Karen has problems transferring across settings. She displays poor posture and
body tone that fluctuates between rigid and flaccid. She has adopted several
behaviours that provide both a distraction and a sensory stimulus when asked to
attempt something. She can drop to the floor without warning when walking or
she may suddenly run. In PE lessons Karen shows glimpses of sound motor
skills and a sense of balance, however Karen is a different person when on the
trampoline. She is literally delighted to be bouncing and teaching assistants have
commented that it is one of the few times that she will show appropriate laughter
and smiling. Karen still struggles to follow instructions when on the trampoline but
she understands that she has to take her shoes off to use it and gets on and off
safely without prompting now. Karen is well-coordinated when bouncing, knows
where she is within her space and uses her body well to keep balance and get
more uplift. For Karen simply being on the trampoline is liberating.
Resources packs can be made that include large symbol action cards and
instruction cards to be held up to support verbal instructions. Physical prompts
can be used where necessary because the operator can be on the trampoline
with the student. Even touch-sensitive children can accept indirect contact when
being manipulated on the parachute, stretch band or by being bounced by the
operator.
I believe that RT offers the PE teacher many options to be resourceful and offers
imaginative programmes to students based upon their interests and needs as a
medium that is motivational to the student. Programmes are easily adapted to be
purely therapeutic or instructional according to the individual, or a combination of
both. Providing RT on a regular basis should be part of a good behaviour
management strategy for most students.
References.

Chartered Society of Physiotherapy (2007) Safe Practice in Rebound
Therapy. London: Chartered Society of Physiotherapy.

Hancock, J. (2003) Rebound Therapy on Children with Motor
Coordination difficulties, Paper supplied as course support material on
Rebound Therapy training course.

Jones, M., Walley, R., Leech, A., Paterson, M., Common, S., and
Metcalf, C. (2006) Using goal attainment scaling to evaluate a needsled exercise programme for people with severe and profound
intellectual disabilities, Journal of Intellectual Disabilities, 10, 4, pp
317‒335.

Jones, M., Walley, R., Leech, A., Paterson, M., Common, S., and
Metcalf, C. (2007) Behavioral and Psychosocial Outcomes of a 16Week Rebound Therapy-Based Exercise Program for people With
Profound Intellectual Disabilities, Journal of Policy and Practice in
Intellectual Disabilities, 4, 2, pp 111-119.

Saturn V (2004) The Benefits of Trampolining for People with Special
Needs. Paper supplied as course support material on Rebound
Therapy training course.

Miller, A. (2007) Rebound Therapy – Where is the Evidence? Paper
supplied as course support material on Rebound Therapy training
course.

National Rebound Therapy Consultancy, (2008) Eddy Anderson, the
founder of Rebound Therapy, answers the question: What is Rebound
Therapy? Paper supplied as course support material on Rebound
Therapy training course.

Randell, R. and Du-Mont, L. (2005) Rebound Therapy; Health and
Education Working Together to bring about just the right challenge!
Local health Board Powys, PowerPoint.